Tag: causes of scoliosis

How common is Scoliosis?

Posted on December 2, 2023 by - Blog

Scoliosis is a condition that affects the curvature of the spine. The spine has a natural curve, backwards and forwards, but in Scoliosis the spine curves excessively from side to side.  The condition can affect people of all ages, but it is most commonly diagnosed in children and adolescents. In this blog post, we will explore how common scoliosis is and the different factors that can contribute to the development of the condition.

 

How Common is Scoliosis?

Scoliosis is a relatively common condition, with an estimated prevalence of 2-3% in the general population. This means that about 2-3 people out of 100 have some degree of scoliosis. The condition is more common in girls than boys, and it tends to run in families. According to the American Association of Neurological Surgeons (AANS), approximately 80% of scoliosis cases have no known cause, and the condition is often diagnosed during routine school screenings. This of course isn’t the case in the UK, since school screenings are not provided!

There are different types of scoliosis, and the prevalence of the condition varies depending on the type. Idiopathic scoliosis, which is the most common type, accounts for about 80% of all cases of scoliosis. This type of scoliosis occurs for no known reason (which means that we don’t yet know why, not that there is no reason at all!) and can develop at any age – it is most commonly diagnosed in adolescents between the ages of 10 and 18.

Another type of scoliosis is congenital scoliosis, which is present at birth and is caused by abnormal spinal development. Congenital scoliosis is less common than idiopathic scoliosis and accounts for about 10% of all cases of scoliosis in children. Neuromuscular scoliosis is another type, which is caused by underlying neuromuscular conditions such as cerebral palsy. Overall, congenital cases are a much smaller percentage of cases, but it’s still a condition which is seen fairly often.

Degenerative scoliosis is also known as adult scoliosis, and it typically develops in people over the age of 50. As people age, the discs in the spine start to wear down, and the vertebrae can begin to shift and rotate, leading to scoliosis. Other factors that can contribute to the development of degenerative scoliosis include osteoporosis, arthritis, and other spinal conditions. Degenerative scoliosis is actually the most common form of Scoliosis – as many as 1 in 3 people over the age of 60 suffer from the condition.

 

Does Age Contribute to the Development of Scoliosis?

The exact cause of scoliosis is unknown, but researchers have identified certain factors that may contribute to the development of the condition. While age is one of these, it’s just one of many factors. These include:

Genetics

Scoliosis tends to run in families, which suggests that there may be a genetic component to the condition. Researchers have identified several genes that may be associated with scoliosis, but more research is needed to understand the role of genetics in the development of the condition.

Gender

Scoliosis is more common in girls than boys, particularly in adolescent idiopathic scoliosis. This may be due to differences in hormonal levels or the fact that girls tend to go through growth spurts earlier than boys. This difference tends to even out in adult and degenerative Scoliosis cases.

Neuromuscular conditions

Neuromuscular conditions, such as cerebral palsy and muscular dystrophy, can also contribute to the development of scoliosis. These conditions affect the muscles and nerves that control the spine, leading to abnormal curvature.

Posture and body mechanics

Poor posture and body mechanics don’t cause Scoliosis, but they might contribute to worsening it. One group which has a particularly high incidence of Scoliosis is ballet dancers and gymnasts – one theory suggests that contorting the body as required in these activities might worsen scoliosis.

Spinal conditions

Certain spinal conditions, such as herniated discs and spinal stenosis, can also contribute to the development of scoliosis in older people. These conditions can cause the vertebrae to shift and rotate, leading to abnormal curvature.

 

 

What causes scoliosis? (and what doesn’t)

Posted on March 1, 2019 by - Blog

Perhaps one of the most common questions we are asked about scoliosis is simply “what causes scoliosis” – a quick google search yields far less information than you might think since in many cases the answer is still “we aren’t sure”. At the UK Scoliosis clinic, we like to provide all the information we can, however, so here’s a bit more detail on the latest thinking as to what does and does not cause scoliosis.

 

What does cause scoliosis?

While research is ongoing, it’s a sad fact that it’s still not possible to say for sure what causes the majority of scoliosis cases. At this point, however, there are 5 major possibilities to consider:

 

Possibility number 1 –  we don’t know.

80% of scoliosis cases are idiopathic – which means we don’t really know the cause!

Scoliosis can be a frustrating diagnosis, especially for many parents, since in young people at least 80% of cases are what’s known as “idiopathic” – this literally means “without known cause”.  There is much research going on to determine the case of scoliosis, but (as unhelpful as it might be) we’ve put this answer first because when dealing with young people, it’s overwhelmingly likely to be the answer. To all parents reading this, we can at least reassure you that the presence of scoliosis is certainly not an indicator that you “did something wrong” – all of the evidence so far points to a genetic cause or one of the following other conditions.

Today, treating idiopathic scoliosis is easier than ever before- and with specialist clinics like the UK Scoliosis clinic, success rates are very high.

 

Possibility number 2 – Neurological or congenital causes.

If 80% of scoliosis cases (in children) are idiopathic, that leaves about 20%. Of this 20 %, neurological or congenial causes are one of the major possibilities. Scoliosis can be a symptom of conditions such as Cerebral palsy or Muscular dystrophy or of Genetic disorders like Marfans syndrome and Downs syndrome.

Congenital scoliosis begins as a baby’s back develops before birth. Problems with the formation of the bones which make up the spine (called vertebrae), can cause the spine to curve. The vertebrae may be incomplete, fail to divide properly or develop in an abnormal shape. Doctors may detect this condition when the child is born but it is also often detected during scoliosis screening.

Depending on the underlying condition, different treatments will be required to achieve the best results.

 

Possibility number 3 – Genetics

It is generally accepted amongst the scoliosis treatment community that having a family history of scoliosis does predispose you to a higher risk of developing scoliosis yourself. This is common with many conditions, so seems like a reasonable assumption. Since we don’t know the exact mechanism which causes scoliosis, to begin with, it’s also hard to say for certain that genetic inheritance is certainly a risk factor, but it seems highly likely. Possible genetic markers for scoliosis are one of the most intense fields of research at present, so hopefully, we will know more soon.

 

Possibility number 4 – Degeneration of the spine

Degenerative scoliosis is very common in the over 60’s

“De-novo” or degenerative scoliosis is a common form of scoliosis, which affects nearly 40% of the population over 60. Unlike childhood scoliosis, de-novo scoliosis is well understood. It’s the result of the gradual degeneration of the spinal bones due to wear and tear with age.

Many of the same treatments used for idiopathic scoliosis are effective in slowing and preventing de-novo scoliosis from developing.

 

Possibility number 5 – Non-structural scoliosis

All of the above conditions result in what is collectively called “structural scoliosis” – that is to say a condition where the spine itself is actually curved as a primary condition. Another possibility is the presence of “non-structural scoliosis” – a condition where the spine appears to be curved, but only as the result of an associated condition. Whereas structural scoliosis treatment cases required direct intervention to correct scoliosis, non-structural cases will usually resolve when the root cause is addressed.

Non-structural scoliosis might be apparent on a short-term basis as a result of a condition causing significant inflammation, such as appendicitis – over the long term, factors such as a leg length discrepancy can cause the spine to curve as the body tries to compensate.

 

Possibility number 6 – Some activities

It’s possible (but not confirmed) that some activities which involve significant distortion to the spine may cause scoliosis. At least one study has suggested that dangers and gymnasts are up to 12 times more likely to develop scoliosis than individuals who do not participate in these activities[1] – but it’s important to remember that correlation does not necessarily mean causation.

 

What does not cause scoliosis?

Perhaps just as important as the question of what does cause scoliosis, is the question of what does not. There is much misinformation to be found in this realm, so let’s clear up a few common ones now!

Posture

While many of us associate young people with poor posture – and scoliosis can cause postural issues, there is no evidence which suggests that having poor posture can actually cause scoliosis (although it is much more strongly associated with kyphosis – read more about that here).

 

Injury

While it has been suggested that childhood injuries could be responsible for scoliosis, there is no strong evidence to suggest this is the case. While recent research has suggested that being involved in impact sports, or even “heading” the ball too much when playing football could predispose the cervical spine to degeneration later in life[2] there is no evidence that scoliosis can result.

 

Diet

Heavy backpacks don’t cause scoliosis (but should be avoided anyway!)

 

For some time, some researchers have suggested that certain diets may help to improve scoliosis. Although there is currently no evidence which suggests that diet can improve scoliosis, at least one study has noted that many idiopathic scoliosis patients also have lower selenium levels than normal.[3] While this is an interesting observation, there is nowhere near enough evidence to suggest that selenium deficiency or any other nutritional factor is responsible for scoliosis.

 

Heavy backpacks

While heavy backpacks are to blame for many childhood spinal complaints, (ideally, keep backpacks to less than 10% of body weight) scoliosis isn’t one of them. Similarly, while it’s best for patients with scoliosis to avoid uneven loading of the spine (so carrying a backpack on one shoulder isn’t a good idea) there no research to suggest that carrying your back this way can cause scoliosis in the first place.

 

 

 

[1] Prevalence and predictors of adolescent idiopathic scoliosis in adolescent ballet dancers’

Longworth B., Fary R., Hopper D, Arch Phys Med Rehabil. 2014 Sep;95(9):1725-30. doi: 10.1016/j.apmr.2014.02.027. Epub 2014 Mar 21.

[2] Pain Physician 2005:8391-7

[3] Yalaki, Zahide et al. Investigation of Serum Levels of Selenium, Zinc, and Copper in Adolescents with Idiopathic Scoliosis Dicle Medical Journal / Dicle Tip Dergisi. 2017, Vol. 44 Issue 1, p35-41.